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A Novel Virtual Prefabrication of Commercial Reconstructive Plate for Fibular Mandible Reconstruction: A Comparative

Fan Xu^1,2, Dongqing Miao³, Jinbo Wan^1,2

¹State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Jiangsu Province Engineering Research Centre of Stomatological Translational Medicine, Nanjing Medical University.

The Journal of Craniofacial Surgery

|July 7, 2025

Abstract

Purpose:

This study aims to investigate the feasibility of a novel method of virtual prefabrication of commercial reconstructive plate for fibular mandibular reconstruction and to compare its accuracy with 3D printing plate.

Materials And Methods:

Cases of mandibular segmental defects reconstructed with free fibular flap (FFF) were selected. The commercial reconstructive plate was scanned with CBCT and adjusted on the surface of fibular mandibular reconstruction by Rhino 7 software with "Bend Along Curve Function". The 3D model with plate hole landmarks was then designed and printed by Materialise Magic 22.0 software for pre-bending the commercial reconstructive plate, making sure all holes of the commercial reconstructive plate fitting in the hole landmarks. The pre-bent commercial reconstructive plate was used in the real surgery setting as prefabricated plate group. The model surgery of the same case was performed with 3D printing reconstructive plate as control group. The reconstruction deviations were characterized by comparing the reconstructed mandible of 2 groups with the virtually designed mandible using E-3D software with establishing a thermal imaging view and chromatography analysis.

Results:

A total of 10 cases were included in this study. The thermal imaging results of E-3D analysis displayed a wonderful image conformance both in prefabricated plate and 3D printing plate groups. The reconstructive deviations of overall, fibular segments and native mandible in prefabricated plate group is 1.542±0.648, 1.528±0.522, and 1.654±0.612 mm, showing no significant difference in contrast with 1.486±0.6, 1.483±0.605, and 1.620±0.644 mm in 3D printing plate group, respectively.

Conclusions:

On the basis of the novel method of virtual prefabrication, the commercial reconstructive plate was precise of directly completing the hole transferring from reconstructive plate to mandibular osteotomy and FFF cutting guides, which could reduce the arbitrariness of manual pre-bending and ensure the accuracy of fibular mandibular reconstruction.

Keywords:

3D printing reconstructive plate commercial reconstructive plate free fibula flap segmental mandible reconstruction virtual prefabrication

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